Tommy John Surgery: UCL Repair and Reconstruction
What is an ulnar collateral ligament (UCL)?
The ulnar collateral ligament (UCL) is vital to maintaining elbow stability and function. However, this ligament is a common injury associated with several different sports, especially throwing sports such as baseball, javelin, and football. Although this is usually a chronic injury, the UCL can also be ruptured by a fall on an outstretched hand or similar trauma.
What happens During Tommy Johns Surgery?
(UCL Repair Surgery)
Surgery is not normally indicated for most patients but may be necessary for athletes in order to help them fully recover. The ligament is reconstructed using another ligament from the patient’s own body (autograft), most likely from the forearm, hamstring, or knee. The palmaris longus tendon is a commonly used replacement, and it is threaded through holes drilled by the surgeon in a figure-8 style, thus ensuring adequate tension.
The elbow is then immobilized for one to two weeks, after which shoulder range of motion exercises can be performed. Most athletes do not return to play for a year or more. However, most patients eventually regain full strength and function after a lengthy recovery, with some athletes playing more successfully than they did before surgery.